Minimal invasive prothetische Versorgung als wertvolle Alternative zum kieferorthopädischen Lückenschluss bei Zahnnichtanlagen

Zusammenfassung

Untere, aber auch obere zweite Prämolaren und obere laterale Schneidezähne sind die am häufigsten nicht angelegten Zähne; nicht selten sind auch untere Schneidezähne und erste Prämolaren nicht angelegt. Im Rahmen einer kieferorthopädischen Gesamttherapie ist der kieferorthopädische Lückenschluss eine wertvolle Therapieoption, die aber längst nicht für alle betroffenen Patientenfälle in Frage kommt.

In diesen Fällen sollten die Lückenbreiten der nicht angelegten Zähne zum Abschluss der kieferorthopädischen Therapie auf adäquate Dimensionen eingestellt sein, um die Lücken jugendlicher Patienten restaurativ zu versorgen. Minimal invasive Adhäsivbrücken wurden lange Zeit von vielen nur als provisorische Versorgung zur Überbrückung der Zeit bis zu einer geplanten „definitiven“ Versorgung mit dentalen Implantaten angesehen.

Neuere wissenschaftliche Erkenntnisse zeigen jedoch, dass insbesondere einflügelige Adhäsivbrücken zum Schneidezahnersatz exzellente Langzeitergebnisse aufweisen, die denen von Einzelzahnimplantaten nicht nachstehen oder sogar überlegen sind. Aber auch der Ersatz von nicht angelegten Prämolaren mit einflügeligen Adhäsivbrücken ist sehr vielversprechend.

Dieser Beitrag fasst den wissenschaftlichen Stand der Versorgung von Patienten mit minimal invasiven Adhäsivbrücken unter besonderer Berücksichtigung der Versorgung jugendlicher Patienten mit Zahnnichtanlagen zusammen.

Abstract

Mandibular, but also maxillary second premolars and lateral incisors are the most common congenitally missing teeth. However, it is not uncommon for mandibular incisors and first premolars to be congenitally missing as well. As part of an overall orthodontic therapy, orthodontic gap closure is a valuable treatment option, but it is far from being an option for all affected patients. In these cases, the gap width of the missing teeth should be adjusted to adequate dimensions at the finalization of the orthodontic therapy in order to restore the gaps in adolescent patients prosthetically. For a long time, minimally invasive resin-bonded fixed dental prostheses (RBFDPs) were considered by many to be only temporary restorations to bridge the time up to a planned “definitive” restoration with dental implants.

However, more recent scientific findings show that single-retainer RBFDPs in particular offer excellent long-term results for the replacement of incisors, which are not inferior or even superior to those of single-tooth implants. Also, the replacement of missing premolars with single-retainer RBFDPs is very promising.

This article summarizes the scientific status of the treatment of patients with minimally invasive RBFDPs with special reference to the treatment of adolescent patients with congenitally missing teeth.

Schlüsselwörter

Adhäsivbrücken - Indikation - Klebebrücken - Langzeitbewährung - Lückenschluss - Vollkeramik - Zirkonoxidkeramik

Key words

adhesive bridges - gap closure - indication - longevity - resin-bonded fixed dental prostheses - zirconia ceramic

Publication History

Article published online:
07 July 2021

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